Authors (including presenting author) :
Wong KY(1), Chan MC(1), Chiu MWT(1), Li KCJ(1), Ng CY(1), Leung SK(1), Wong SCM(1), Jalal K(1)
Affiliation :
(1) Department of Paediatric and Adolescent Medicine, Queen Mary Hospital
Introduction :
World Health Organization stated that KC should be viewed as standard of care for preterm infants. Evidences showed that KC has many benefits to preterm infants in NICU, such as reducing stress hormone, length of stay(LOS) and morbidity. However, initiation of first KC of preterm infants are commonly delayed due to multiple reasons. From July to September 2023, only 41% preterm infants admitted to QMH NICU received KC and the mean age of initiation of KC of preterm infants was 28.1 days, which lagged behind the international standard. Therefore, this project is implemented to help preterm infants in NICU to initiate KC at an earlier age.
Objectives :
The objectives of this project are:
(1) To decrease the mean age at KC initiation of preterm infants by 10%
(2) To increase the any KC rate of preterm infants in NICU by 10%
(3) No adverse event related to KC (e.g. moderate hypothermia, line dislodgement etc.)
(4) To reduce LOS of moderate preterm infants in NICU by 10%
(5) To increase the rate of exclusive breast milk feeding on discharge of preterm infants by 2% (76)
Methodology :
A multidisciplinary KC workgroup, which included nurses and neonatologists was formed, education program and skill training were provided for all nurses and they have to pass competency assessment. The KC guideline was reviewed based on new evidences and more infants became eligible to KC in their early life, interventions were added to enhance safety during KC. Major changes of the guideline included:
(1) Develop observation checklist for KC to ensure adequate monitoring of temperature of infant during KC.
(2) Provide “Kangaroo Wrap” to parents to help them to secure infant to their chest during KC to enhance safety
(3) Eligibility of KC of intubated infants will be decided by joint discussion of doctors and nurses in daily ward round
The project started in July 2024. Data from July to September in 2023 and 2024 was reviewed.
Result & Outcome :
The outcomes of this project were:
(1) The mean age at KC initiation of preterm infants was reduced by 15.3 days, which was a reduction of 54.6%. (p =0.038)
(2) Any KC rate of preterm infants increased by 29% (p = 0.051)
(3) No occurrence of adverse event related to KC
(4) LOS of moderate preterm Infants reduced by 53.7% (p= 0.023)
(5) The rate of exclusive breast milk feeding on discharge of preterm infants increased by 2.23% (p = 0.936)
